Individual provider Active NPI

Mary E Dumouchelle, MS, RN, FNP-BC

  • Family Nurse Practitioner
  • Athens, OH
National Provider Identifier
1568744753
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12422-NP Issued in OH
Practice address
55 Hospital Dr
Athens, OH 45701-2302
Phone
(740) 566-4828
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 311545 OH
Family Nurse Practitioner 363LF0000X 12422-NP OH Primary

Addresses

Primary practice location

55 Hospital Dr
Athens, OH 45701-2302

Mailing address

75 Hospital Dr
Ste 300
Athens, OH 45701-2860
Phone (740) 566-4644

Other names 1

  • Mary E Buffenbarger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000677 OH Practitioner - Nurse Practitioner 0446423172 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Ohio LLCGroup PAC ID 9032527221, 232 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Springfield, OH 45504-2687
Phone (937) 523-1461

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
311545OHMDRegistered Nurse
12422-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation CurrentSince Jan 1, 2021 Accepting new patients
Usacs Integrated Acute Care Services of Ohio, LLC CurrentSince Apr 27, 2023 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD CurrentSince Jan 1, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Feb 1, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Feb 1, 2020 Accepting new patients
Hospitalist Medicine Physicians of Ohio-Columbus II Professional Corp CurrentSince Jan 1, 2021 Accepting new patients
Riverside Radiology and Interventional Associates Inc Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

75 Hospital Dr
Ste 310
Athens, OH 45701
Phone (740) 594-6100

55 Hospital Dr
Athens, OH 45701
Phone (740) 592-9349

75 Hospital Dr
Ste 260
Athens, OH 45701
Phone (740) 594-8819

75 Hospital Dr
Ste 300
Athens, OH 45701

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

181 Taylor Ave
Columbus, OH 43203
Phone (614) 257-2358

3000 Mack Rd
Hamilton, OH 45014
Phone (513) 870-7000

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1568744753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HOSPITAL DR",
            "address_2": "STE 300",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012860",
            "telephone_number": "740-566-4644",
            "fax_number": "740-566-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOSPITAL DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012302",
            "telephone_number": "740-566-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMOUCHELLE",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "MS, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "311545",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "12422-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BUFFENBARGER",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.